So, periodist's longest tendon autograft is a promising graft for ACL reconstruction. This is my disclosure. We know over the past decade, there has been a lot observed in ACL ruptures due to the support injuries or other causes, and reconstruction is performed to restore functional stability to the ACL deficiency knee and prevent further damage. Graft selection is an important step as the goal is to achieve an effective biological connections between the graft and bone and ensuring optimum osteointegration. As for the graft, we know that it's being used in hamstring, quadriceps, and BTB with their own pros and cons. The periodist's longest tendon shows promises with favorable results on strength and donor site morbidity in initial studies. But the question now, can periodist's longest tendon autograft be a good alternative for the ACL reconstructions? Our study compared the clinical outcome, donor site morbidity of ACL reconstructions with a hamstring tendon autograft with the periodist's longest autograft in patient with an isolated ACL injury. This is a 34-year-old male patient came with a complaint of instability. His left knee gave out while walking. This was after he sustained a support injury 11 months ago in which he described hearing a popping sound. Medical examination shows no swelling and positive anterior drover, lagman test, and pivot shift. These videos describe the surgical technique, put patient in supine, first identify the lateral malleolus, and mark the location for the skin incisions 2 to 3 centimeters above and 1 centimeters behind the lateral malleolus, and then mark 3 centimeters for the skin incisions. Next is identify the periodist's longest nerve, which is located just under the fibular head. Mark 4 to 5 centimeters below the fibular head. Then we start to make a 3 centimeters incisions until the periodist's retinaculum. With a blunt dissection, identify the periodist's longest tendon. Take the distal part of the periodist's longest, then release it from the surrounding soft tissue proximally. And then we repeat the same procedures to identify the periodist's bravest tendon. And next is to tenodize both the periodist's longest and the periodist's bravest tendon 2 centimeters distally and suture the distal part of the periodist's longest tendon to the periodist's bravest with an end-to-side sutures. Then we cut the periodist's longest proximal to the tenodesis. Then we are ready now to strip the periodist's longest tendon proximally with a closed-tendon stripper to about 4 to 5 centimeters from the fibular head to prevent parietal nerve injury. Pay attention to the period nerve as it laid approximately about 3 finger breadth below the fibular head. And while stripping, the tendon carefully stopped the stripper at the second mark. And now the periodist's tendon autograft is now successfully hard-fisted. Clear the area of fibrous tissue for visualizations and tunnel preparations. After preparation, whip stitch the tendon with the fiber loop to reinforce it. And the graft was then fixed to the proper tensioning. There's some possible complication. One is the perineal nerve injury can be avoided by stopping 4 to 5 centimeters below the fibular head. Perineal tendons and a bumpy harf or side can be prevented by remembering to close the fascia afterward. And tenodesing the periodist's longest to bravies is important to avoid the reduced aversion and first-rate plantar flexion and ankle instability. If you look at the result, it shows that the mean diameter of the periodist's longest autograft was significantly larger than the hamstring tendon, with a mean difference of 0.6 millimeters. A single-bundle ACL reconstruction using the periodist's longest autograft shows a comparable functional score to the hamstring, but with less donor-side morbidity. And it has an excellent functional outcome. It shows comparable result to the four-strand hamstring tendon with no donor-side morbidity evaluations. So in my conclusions that the use of periodist's longest autograft in primary ACL reconstruction is a safe procedure with an excellent outcome. And our long-term follow-up of the five years will be published soon. Thank you very much.

ACL reconstruction

graft selection

periodist's longest tendon autograft

surgical technique

donor-site morbidity